The effects of maternal sickle cell hemoglobinopathies and sickle cell trait on reproductive performance

Reproductive performances have been analyzed for 797 black women whose red cells contain sickle cell hemoglobin. Fifty pregnancies in 34 women with sickle cell anemia yeilded only 27 infants who survived; there were no maternal deaths, but morbidity was frequent and often intense. Seventy-eight pregnancies in 43 women with sickle cell-hemoglobin C disease culminated in the births of 68 infants who survived; serious maternal morbidity was common, and 2 women died. Thirty-two infants survived from 37 pregnancies in 21 women with sickle cell-beta thalassemia disease; maternal morbidity was comparable to that with sickle cell-hemoglobin C, disease but there were no maternal deaths. The pregnancy experiences for women with sickle cell trait were not different from those of black women whose red cells do not sickle except for twice the frequency of significant bacteriuria. Thus, the only major cause for special concern by women with sickle cell trait who contemplate reproduction is their potential for transmission of one gene for sickling to the off spring.